CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Ventura County Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $27,486
  • Cash Discount Price: $74,609
  • vs. Medicare Baseline: 1.95x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Ventura County Medical Center is $27,486. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74,609. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.95x the Medicare baseline. Located in 300 Hillmont Avenue, Ventura, CA.
Cash / Self-Pay
$74,609

Average discount available for prompt cash payment at this facility.

Insurance Median
$27,486

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$14,116.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $14,116.91 (100%)
Cash / Self-Pay: $74,609 (529%)
Insurance Median: $27,486 (195%)
Cash: $74,609 (529% of Medicare)
Ins. Median: $27,486 (195% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $14,116.91 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Tricare $20,509 145%
Aetna $21,143 - $86,546 150%
Alignment Hp - All Plans $21,143 150%
Blue Shield Mcr Adv $21,143 150%
Humana $21,143 150%
Medicare (plans) $21,143 150%
Scan-All Plans $21,143 150%
UnitedHealthcare $21,777 - $57,794 154%
Hpn Ip/Op Only Medi-Cal $22,025 156%
Kaiser Medi-Cal Ip/Op Only $22,025 156%
Medi-Cal $22,025 156%
Healthnet Mcr Adv $22,200 157%
Western Growers-All Plans $22,211 157%
Clinicas Mcr Adv $24,103 171%
Blue Shield Epn $24,328 172%
Clinicas Comm - All Other Plans $27,486 195%
Imperial-All Plans $27,486 195%
Ntwrk Provdrs-All Plans $27,486 195%
Clinicas Mcal $27,531 195%
Americas Hp Comm Ip/Op Only-All Other Plans $28,543 202%
Hpn Comm Ip/Op Only-All Other Plans $30,023 213%
Gold Coast Medi-Cal-All Plans $32,724 232%
Blue Shield Comm - All Other Plans $38,428 272%
Vchcp-All Plans $41,781 296%
Americas Hp Mcal Ip/Op Only $44,144 313%
Americas Hp Mcr Adv Ip/Op Only $45,447 322%
Healthnet Comm-All Other Plans $82,070 581%
Blue Cross Blue Shield $85,743 607%
Multiplan/Claritev-All Plans $119,374 846%
Three Rivers Ip/Op Only-All Plans $119,374 846%
Ppo Next Ip/Op Only-All Plans $134,296 951%
Cigna $143,575 1017%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Hillmont Avenue, Ventura, CA 93003
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals